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Deutsche medizinische Wochenschrift (1946) · 2010

[Extracorporeal life support given to a 16-year-old girl with cystic fibrosis, candida pneumonia and acute respiratory distress syndrome].

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Kuhl T, Langebartels G, Madershahian N, Wahlers T

Аннотация

HISTORY: Small bowel resection had to be performed because of an acute ileus in a 16-year old girl with mucoviscidosis. Severe respiratory insufficiency developed and she was transferred to the intensive care unit.

INVESTIGATIONS: The clinical signs of a severe ARDS were demonstrated: Horowitz index < 200, pO (2) 57 mm Hg, FiO (2) 1,0, pCO (2) 82 mm Hg. Candida serology was positive (titer 1 : 5120), and there was a leukocytosis (20 000/µl), hypalbuminemia (14 g/l) and elevation of C-reactive protein (190 mg/l).

TREATMENT AND COURSE: Because all non invasive treatment options had failed to improve the patient's condition, an extracorporal membrane oxygenation (ECMO) device was connected. Seven days later, after the pulmonary situation had improved, the device was successfully removed; the patient was discharged in a satisfactory condition after another month.

CONCLUSION: ECMO is a another treatment option for serious ARDS in infection-related worsening of pulmonary cystic fibrosis.

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